Abstract

Some implantable medical devices contain silver. We aimed to assess at what amount implanted silver becomes toxic. Silver was elevated in bodily fluids and tissues surrounding silver-containing implants. Silver released from implants also distributes to blood and other tissues; there is evidence to suggest silver can pass the blood-brain-barrier. Silver can be deposited as nano-sized particles in various tissues. Such particles, in addition to silver, often contain other elements too, e.g., selenium and sulfur. Silver released from implants seems to stay in the body for long periods (years). Reported excretion pathways following implantation are urinary and fecal ones. Reported toxicological effects were virtually all local reactions surrounding the implants. Argyria is a blue-gray discoloration of the skin due to deposited silver granules. Localized argyria has been described after the implantation of acupuncture needles and silver-coated prostheses, although the presence of silver was tested only for and shown in the former. Other toxicological effects include local tissue reactivity and examples of neurotoxic and vascular effects. We did not include genotoxicity studies in the present publication as we recently evaluated silver to be genotoxic. Carcinogenicity studies were absent. We conclude that local toxicity of implanted silver can be foreseen in some situations.

摘要

一些植入式医疗器械含有银。我们的目的是评估植入的银在多少时会变得有毒。含银植入物周围的体液和组织中的银含量升高。植入物释放的银也会分布到血液和其他组织中；有证据表明银可以通过血脑屏障。银可以作为纳米级颗粒沉积在各种组织中。除了银之外，此类颗粒通常还包含其他元素，例如硒和硫。从植入物中释放的银似乎会在体内停留很长时间（几年）。植入后报告的排泄途径是尿液和粪便。报告的毒理学影响几乎是植入物周围的所有局部反应。Argyria 是由于沉积的银颗粒引起的皮肤蓝灰色变色。在植入针灸针和镀银假体后描述了局部银屑病，尽管银的存在仅针对前者进行了测试和显示。其他毒理学影响包括局部组织反应性以及神经毒性和血管影响的例子。我们在本出版物中没有包括遗传毒性研究，因为我们最近评估了银具有遗传毒性。没有进行致癌性研究。我们得出结论，在某些情况下可以预见植入银的局部毒性。我们在本出版物中没有包括遗传毒性研究，因为我们最近评估了银具有遗传毒性。没有进行致癌性研究。我们得出结论，在某些情况下可以预见植入银的局部毒性。我们在本出版物中没有包括遗传毒性研究，因为我们最近评估了银具有遗传毒性。没有进行致癌性研究。我们得出结论，在某些情况下可以预见植入银的局部毒性。